Agreement between cardiac index measured with arterial pressure-based cardiac output and pulmonary artery catheter during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension
10.3760/cma.j.issn.0254-1416.2013.05.018
- VernacularTitle:APCO和PAC监测先天性心脏病重度肺动脉高压患者剖宫产术围术期CI的一致性
- Author:
Jiakai LU
;
He JING
;
Xiuhua DONG
;
Enming QING
;
Weiping CHENG
;
Hui WANG
;
Jinglan ZHANG
- Publication Type:Journal Article
- Keywords:
Heart defects,congenital;
Hypertension,pulmonary;
Monitoring,intraoperative;
Cesarean section
- From:
Chinese Journal of Anesthesiology
2013;33(5):588-591
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine if the cardiac index (CI) measured with arterial pressure-based cardiac output (APCO) agrees with that measured with pulmonary artery catheter (PAC) during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension.Methods Thirty parturients with congenital heart disease and severe pulmonary hypertension,scheduled for elective cesarean section,were enrolled in the study.APCO and PAC were used for cardiac output and other parameters of hemodynamics monitoring during operation in all patients.Continuous epidural anesthesia was performed.CI was recorded immediately before epidural administration (T1),at 5 and 10 min after epidural administration (T2-3),immediately before delivery (T4),and at 2 and 5 min after delivery (T5-6).The correlation was tested by Pearsone correlation analysis.CI derived from APCO and PAC was compared by Bland-Altman analysis for agreement.Results CI measured with PAC was significantly higher than that measured with APCO (P ＜ 0.05).Compared with the baseline value at T1,no significant difference in CI measured with PAC and APCO was found at T11-T4 and T6 (P ＞ 0.05),and CI measured with PAC and APCO was significantly increased at T5 (P ＜ 0.05).Bland-Ahman analysis showed poor agreement between CI measured with the two methods.The correlation analysis showed that there was positive correlation between CI derived from the two methods at T1-6 (the correlation coefficient was 0.93,0.95,0.94,0.89,0.96 and 0.91 at T1-6,respectively,P ＜ 0.05).Conclusion CI value obtained with APCO agrees poorly with that obtained with PAC during cesarean section in parturients with congenital heart disease and severe pulmonary hypertension,but agrees well in monitoring the changing trend of CI.
